It should outrage and frustrate us all that our brave service members and their families—who make immense sacrifices every day to protect our nation—have fewer rights than those they serve to protect. Most people are unaware that while the Affordable Care Act requires coverage of Food and Drug Administration-approved contraception without co-pays, these benefits do not extend to TRICARE, a health-care program for service members and their families.
As the chair of the House Armed Services Military Personnel Subcommittee and a practicing OB-GYN who treats patients covered by TRICARE, we know that military families need and deserve no less than the highest quality contraceptive coverage and care.
Contraception is empowering. It enables people to achieve their educational, economic, and professional goals by allowing them to plan for and space their pregnancies. It’s also basic health care. And for service members and their families, it’s vital to ensuring military readiness, well-being, and equality.
The vast majority of Americans (86 percent) across the political spectrum agree that birth control should be easily accessible. This includes 93 percent of Democrats and 75 percent of Republicans who believe that birth control should be considered basic health care. Yet somehow, in 2021, access to the full range of contraceptive methods is out of reach for our military service members and their families due to lack of access and cost.
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While active-duty service members currently have contraceptive coverage without co-pays, non-active duty service members—including members of the National Guard or Reserves—who are insured under TRICARE do not. The lack of coverage also extends to spouses, children, and other dependents. For them, there can be significant cost barriers depending on what method of birth control they need and where they can access it. More than 1.5 million women of reproductive age are covered by TRICARE; the urgency of addressing this disparity could not be greater.
Fortunately, the Access to Contraception for Servicemembers and Dependents Act would right this wrong. The bicameral bill, introduced in Congress on April 20 by Sen. Jeanne Shaheen, would ensure that all TRICARE beneficiaries receive coverage for the full range of FDA-approved contraceptive methods without co-pays, much like their civilian counterparts.
Research shows that costs associated with contraception, even when small, can lead people to forgo it completely, choose less effective methods, or use it inconsistently. We also know cost barriers to contraception fall hardest on those who already face systemic barriers to achieving their reproductive well-being, specifically Black and brown people and people with lower incomes.
People must be able to choose the method of contraception that’s right for them without those cost barriers, which can run up to $1,000 out of pocket for an IUD or $600 for birth control pills per year. There is no one right method for everyone. In fact, the median number of contraceptive methods ever used by women in the United States is three, and one-third of women have used five or more methods. Often the most effective methods are expensive and can cost hundreds of dollars for the device and visit.
How many of our service members and their families can afford that on the limited salary most live on?
Eliminating co-pays for all TRICARE beneficiaries could increase consistent use of contraception, eliminate cost barriers to using the method best for an individual, and help service members and their families—who serve as well.
Our service members and their families should have all the same contraceptive options as those they risk their lives for. The Access to Contraception for Servicemembers and Dependents Act would make that a reality. By eliminating cost barriers, our service members and their families will be able to take their reproductive well-being and their goals for their families and careers into their own hands. It’s the very least we can do for them.
Rep. Speier is the sponsor of the House bill.